(before any rebate, loading or discount)
Covers only one person
Available in Western Australia
Closed to new members
# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading, an age-based discount or an insurer discount. Check with your insurer for details.
This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.
| Assisted reproductive services | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Back, neck and spine | Gastrointestinal endoscopy | Pain management |
| Blood | Gynaecology | Pain management with device |
| Bone, joint and muscle | Heart and vascular system | Palliative care |
| Brain and nervous system | Hernia and appendix | Plastic and reconstructive surgery (medically necessary) |
| Breast surgery (medically necessary) | Hospital psychiatric services | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Cataracts | Implantation of hearing devices | Pregnancy and birth |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Rehabilitation |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Joint replacements | Sleep studies |
| Dialysis for chronic kidney failure | Kidney and bladder | Tonsils, adenoids and grommets |
| Digestive system | Lung and chest | Weight loss surgery |
| Ear, nose and throat | Male reproductive system |
The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.
Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.
Excess: You will have to pay an excess of $250 per admission. This is limited to a maximum of $250 per person and $250 per policy per year.
Co-payments: No co-payments
Waiting periods:
This provider offers 'known gap' or 'no gap' cover for medical bills for this product.
The Medical Costs Finder lets you find out more about the cost of specialist medical services.
This health insurer does not operate a preferred provider scheme.
| Note, for items marked with an asterisk *: *100% benefit available on preventative dental services- includes items 012, 013, 111, 114, 115, 121, 161. Claimable once per appointment, up to twice per person per calendar year. | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental* | 2 | $1,500 per policy (combined limit for general dental, major dental, endodontic & orthodontic - Sub-limits apply) | Periodic oral examination - $32.85 Scale & clean - $62.10 Fluoride treatment - $21.60 |
| Major dental* | 12 | Surgical tooth extraction - $144.00 Full crown veneered - $787.00 | |
| Endodontic* | 2 | Filling of one root canal - $153.00 | |
| Orthodontic* | 12 | Braces for upper & lower teeth, including removal plus fitting of retainer - 80% of charge | |
| Optical | 6 | $200 per policy (combined limit for optical & other services) | Single vision lenses & frames - 80% of charge Multi-focal lenses & frames - 80% of charge |
| Non PBS pharmaceuticals* | 2 | $250 per policy (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - $45.00 |
| Physiotherapy | 2 | $400 per policy (combined limit for physiotherapy, remedial massage, exercise physiology & other services - Sub-limits apply) | Initial visit - $45.00 Subsequent visit - $33.30 |
| Chiropractic | 2 | $400 per policy (combined limit for chiropractic, acupuncture, osteopathy & other services) | Initial visit - $36.00 Subsequent visit - $27.00 |
| Podiatry | 2 | $200 per policy (combined limit for podiatry & orthotics (podiatric orthoses)) | Initial visit - $39.60 Subsequent visit - $30.60 |
| Acupuncture | 2 | Combined limit - see Chiropractic | Initial visit - $22.50 Subsequent visit - $22.50 |
| Remedial massage | 2 | Combined limit - see Physiotherapy | Initial visit - $25.00 Subsequent visit - $22.50 |
| Blood glucose monitors | 2 | $150 per policy (combined limit for blood glucose monitors & other services) | Per monitor - 80% of charge |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $35.00 Subsequent visit - $27.00 |
| Eye therapy (orthoptics) | 2 | $300 per policy (combined limit for eye therapy (orthoptics), occupational therapy & speech therapy - Sub-limits apply) | Initial visit - $40.50 Subsequent visit - $39.60 |
| Health management / Healthy lifestyle | 2 | $100 per policy (combined limit for health management / healthy lifestyle & other services) | Health management - 80% of charge |
| Occupational therapy | 2 | Combined limit - see Eye therapy (orthoptics) | Initial visit - $54.00 Subsequent visit - $36.00 |
| Orthotics (podiatric orthoses) | 2 | Combined limit - see Podiatry | Orthotics supply & fit - 80% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $36.00 Subsequent visit - $27.00 |
| Speech therapy | 2 | Combined limit - see Eye therapy (orthoptics) | Initial visit - $76.50 Subsequent visit - $40.50 |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $45.00 |
| **Overall Dental limit $1500 with Sub Limits of $1000 each on: Crowns & Bridges; Implants; Inlays, Onlays & Veneers. Lifetime Limit of $1000 on Orthodontics | |||
| Hearing aids | Psychology | Other treatments - check with your insurer |
In Western Australia this policy provides:
Emergency: Unlimited with a waiting period of 1 day.
Non-emergency: Unlimited transport with a waiting period of 1 day, or 1 day for pre-existing conditions.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.
For information on what is covered under each category, see https://www.privatehealth.gov.au/categories
Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.
These categories are not covered by this policy.